In this controlled, single-blind parallel group study, the effect of ibuprofen 1200 mg daily was compared with diclofenac 75 mg daily. Thirty patients entered the study, randomized into two groups, each group receiving one tablet three times daily for two weeks. A one-week wash-out period (i.e. a drug-free period during which only physiotherapy was given), preceded and followed the treatment on active drug. Assessments were made by the same clinician throughout who was unaware of the treatment of individual patients. Statistically significant improvement was shown by patients receiving ibuprofen for the degree of pain relief at rest and improvement was also shown for the degree of pain at rest and during exercise, for pain relief during exercise and for spinal flexion. Patients who received diclofenac showed statistically significant improvement for forward flexion, together with improvement for the degree of pain on exercise. Side-effects were very few.
A double-blind crossover trial of 200 mg flurbiprofen daily and 100 mg indomethacin daily, each given for 2 weeks separated by a 1-week placebo washout period, was carried out in 30 patients with rheumatoid arthritis. The results were analyzed for the 26 patients with complete records. No statistically significant differences were found between the two treatments with regard to subjective impression of pain severity, duration of morning stiffness, grip strength, joint size, haemoglobin and erythrocyte sedimentation rate. When the results for each treatment period were compared to baseline and both drugs considered individually, there was a statistically significant improvement from baseline. During the flurbiprofen treatment period the erythrocyte sedimentation rate showed a statistically significant fall, but not with indomethacin. During the placebo washout period between the active therapies, there was a statistically significant worsening in all parameters apart from the level of haemoglobin and erythrocyte sedimentation rate. These assessments showed little change. Five patients reported side-effects with indomethacin, and 1 with flurbiprofen. No side-effects were reported during the placebo period and although 4 patients were withdrawn, none was withdrawn because of side-effects. Patient preference was for flurbiprofen.
Forty patients took part in an observer-blind multiple dose crossover study to compare the efficacy and tolerability of 300 mg flurbiprofen (100 mg twice a day orally and 100 mg suppository at night) with 75 mg diclofenac sodium (25 mg twice daily orally and 25 mg suppository at night) in the relief of night pain and morning stiffness in patients with osteoarthritis. Equal numbers of patients were randomized to receive one of the treatments for the first 7-day treatment period and then the other treatment for the second 7-day treatment period. There were significant differences in favour of flurbiprofen for the reduction in night pain, improvement in quality of sleep and patients' assessment of overall improvement on treatment. Two patients withdrew from the study due to side-effects experienced whilst taking diclofenac sodium during the first treatment period. Eight patients in all reported a total of 18 side-effects during this study. Six patients reported 12 side-effects whilst taking diclofenac sodium compared with three patients who reported six side-effects whilst taking flurbiprofen. This study confirms the good efficacy and tolerability of flurbiprofen in the symptomatic relief of osteoarthritis.
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